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  • Open Access

    REVIEW

    Sodium-Glucose Cotransporter 2 Inhibitors in Adult and Pediatric Congenital Heart Disease: Review of Emerging Data and Future Directions

    William H. Marshall V1,2,*, Lydia K. Wright2

    Congenital Heart Disease, Vol.19, No.4, pp. 419-433, 2024, DOI:10.32604/chd.2024.056608 - 31 October 2024

    Abstract Heart failure (HF) is common in patients with congenital heart disease (CHD) and there are limited medical therapies. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a proven medical therapy in patients with acquired HF, though data are limited in patients with CHD. The aim of this review is to summarize the current evidence for use of SGLT2i in patients with CHD and identify future directions for study. In available publications, SGLT2i in patients with CHD seem to be well tolerated, with similar side effect profile to patients with acquired HF. Improvement in functional capacity and natriuretic More >

  • Open Access

    ARTICLE

    The Impact of a Prior Norwood Procedure on Cardiac Transplantation in Failed Fontan Physiology

    Ryan G. McQueen1, Nikki M. Singh2, Ronald K. Woods3,*

    Congenital Heart Disease, Vol.19, No.3, pp. 257-266, 2024, DOI:10.32604/chd.2024.052108 - 26 July 2024

    Abstract Objective: The objective of this study was to compare cardiac transplant operative and postoperative courses of patients with failed Fontan physiology who were initially palliated with a Norwood (FFN) to those without a prior Norwood (FF). Methods: A single-institution retrospective review of all patients with Fontan failure who underwent cardiac transplantation from 2003–2021 was completed—22 underwent prior Norwood (FFN) and 11 did not (FF). Descriptive and inferential statistics were calculated for operative course and patient outcomes. Results: The operative course of the FFN cohort appeared to be more complex (not statistically significant, but clinically relevant)—this group… More >

  • Open Access

    ARTICLE

    Comparison of 2D and 4D Flow MRI Measurements for Hemodynamic Evaluation of the Fontan Palliation

    Elisa Listo1,#, Nicola Martini2,#, Stefano Salvadori3, Elisa Valenti3, Nicola Stagnaro1, Gianluca Trocchio4, Chiara Marrone5, Alberto Clemente6, Francesca Raimondi7,*, Pierluigi Festa5, Lamia Ait Ali5,8,*

    Congenital Heart Disease, Vol.18, No.6, pp. 627-638, 2023, DOI:10.32604/chd.2023.030312 - 19 January 2024

    Abstract Background: The assessment of Fontan circuit’s flow is traditionally evaluated by multiple through-plane phase-contrast MRI acquisitions (2D flow), while recently, a single volumetric 4D-flow MRI acquisition is emerging as a comprehensive tool for the hemodynamic evaluation in congenital heart diseases. Purpose: To compare 2D and 4D-flow MRI measurements in patients after Fontan palliation and to evaluate parameters affecting potential disagreement. Methods: 39 patients after Fontan palliation (23 males, age 22 ± 11 years) who underwent cardiac MRI with 2D and 4D-flow MRI acquisition were included in the study. In all patients, blood flow quantification in the… More > Graphic Abstract

    Comparison of 2D and 4D Flow MRI Measurements for Hemodynamic Evaluation of the Fontan Palliation

  • Open Access

    ARTICLE

    Ventricular Arrhythmia in the Fontan Circulation: Prevalence, Risk Factors and Clinical Implications

    Charis Tan1,2 , Diana Zannino3, Carley Clendenning3, Sophie Offen4, Thomas L. Gentles5, Julian Ayer6, David Tanous7, Vishva Wijesekera8, Leeanne Grigg9, David Celermajer2,4,10, Mark McGuire2,4 , Yves d’Udekem3,11,12, Rachael Cordina2,4,10,*

    Congenital Heart Disease, Vol.18, No.5, pp. 507-523, 2023, DOI:10.32604/chd.2023.028829 - 10 November 2023

    Abstract Objective: Sudden cardiac death (SCD) and malignant ventricular arrhythmia (VA) are increasingly recognized as important issues for people living with a Fontan circulation, but data are lacking. We sought to characterize the cohort who had sudden cardiac death, most likely related to VA and/or documented VA in the Australia and New Zealand Fontan Registry including risk factors and clinical outcomes. Methods: A retrospective cohort study was performed. Inclusion criteria were documented non-sustained ventricular tachycardia, sustained ventricular tachycardia, ventricular fibrillation, resuscitated cardiac arrest or SCD > 30 days post-Fontan completion. Results: Of 1611 patients, 20 (1.2%) had VA;… More >

  • Open Access

    ARTICLE

    Minor Pressure Differences within the Fontan-Anastomosis in Patients with Total Cavopulmonary Connection by 4D-Flow Magnetic Resonance Imaging

    Nerejda Shehu1,*, Christian Meierhofer1, Anja Hennemuth2,3, Markus Hüllebrand2,3, Pavlo Yevtushenko3, Peter Ewert1, Stefan Martinoff4, Heiko Stern1

    Congenital Heart Disease, Vol.18, No.4, pp. 461-474, 2023, DOI:10.32604/chd.2023.031075 - 15 September 2023

    Abstract Background: Pressure measurement in total cavopulmonary connection (TCPC) patients is a domain of cardiac catheterization. 4D velocity encoded cardiovascular magnetic resonance (4D–flow MRI) offers an alternative for assessment of even minor pressure differences. The scope of this study was to measure even minor pressure differences in the anastomosis of TCPC patients, who are clinically uncompromised. Methods: Twenty-four patients (median 15 years [8;34]) with TCPC were studied prospectively by 4D-flow MRI. Pressure differences between superior vena cava (SVC) and extracardiac conduit (C) to both right pulmonary artery (RPA) and left pulmonary artery (LPA) were assessed. Small… More > Graphic Abstract

    Minor Pressure Differences within the Fontan-Anastomosis in Patients with Total Cavopulmonary Connection by 4D-Flow Magnetic Resonance Imaging

  • Open Access

    ARTICLE

    Hemodynamic Profiling Using a Cardiac Index–Systemic Vascular Resistance Plot in Patients with Fontan Circulation

    Yuki Kawasaki1,*, Takeshi Sasaki1, Daisuke Kobayashi2

    Congenital Heart Disease, Vol.18, No.4, pp. 431-445, 2023, DOI:10.32604/chd.2023.030910 - 15 September 2023

    Abstract Background: Elevated Fontan pressure (FP) alone cannot fully predict clinical outcomes. We hypothesized that hemodynamic profiling using a cardiac index (CI)-systemic vascular resistance (SVR) plot could characterize clinical features and predict the prognosis of post-Fontan patients. Methods: We included post-Fontan patients who underwent cardiac catheterization at age < 10 years. Patients were classified into four categories: A, CI  ≥ 3, SVR index (SVRI) ≥ 20; B, CI < 3, SVRI ≥ 20; C, CI ≥ 3, SVRI < 20; and D, CI < 3, SVRI < 20. The primary outcome was freedom from the combined endpoint: new onset of protein-losing enteropathy or plastic bronchitis, heart transplant, and death. Clinical and… More > Graphic Abstract

    Hemodynamic Profiling Using a Cardiac Index–Systemic Vascular Resistance Plot in Patients with Fontan Circulation

  • Open Access

    ARTICLE

    Preliminary Evaluation of Hemodynamic Effects of Fontan Palliation on Renal Artery Using Computational Fluid Dynamics

    Jinlong Liu1,2,#, Jing Shi3,#, Weiru Luo1, Zhirong Tong1,2, Lefei Yang3, Peixuan Sun3, Tianyi Li3, Jun Du3,*, Qian Wang3,*

    Congenital Heart Disease, Vol.18, No.1, pp. 41-55, 2023, DOI:10.32604/chd.2023.025005 - 09 January 2023

    Abstract Background: The assessment of renal function is important to the prognosis of patients needing Fontan palliation due to the reconstructed compromised circulation. To know the relationship between the kidney perfusion and hemodynamic characteristics during surgical design could reduce the risk of acute kidney injury (AKI) and the postoperative complications. However, the issue is still unsolved because the current clinical evaluation methods are unable to predict the hemodynamic changes in renal artery (RA). Methods: We reconstructed a three-dimensional (3D) vascular model of a patient requiring Fontan palliation. The technique of computational fluid dynamics (CFD) was utilized to… More > Graphic Abstract

    Preliminary Evaluation of Hemodynamic Effects of Fontan Palliation on Renal Artery Using Computational Fluid Dynamics

  • Open Access

    REVIEW

    Associations between Bodyweight and Clinical Outcome in Patients Post-Fontan Procedure: A Systematic Review

    Emma Payne1,2, Thomas Wilson2,3, Marjan Haghighi1,4, Zoe McCallum2,3, Yves d’Udekem5, Julian Ayer1,4,*

    Congenital Heart Disease, Vol.17, No.6, pp. 617-639, 2022, DOI:10.32604/chd.2022.024775 - 11 October 2022

    Abstract Background: Patients born with a single ventricle circulation commonly experience growth failure in early life, which is associated with adverse outcomes in infancy. However, associations between bodyweight or weight trajectory and clinical outcome post-Fontan procedure are yet to be determined. Methods: On the 1st of July 2021, a systematic review was performed in MEDLINE, EMBASE, the Cochrane Library, and Scopus of studies of patients with clinical outcome data post-Fontan procedure and association with bodyweight. Quality of studies was evaluated by Newcastle–Ottawa scale for cohort studies and Joanna Briggs Institute tool for cross-sectional studies. Results: Of 527 studies… More >

  • Open Access

    ARTICLE

    A 20-Year Follow-up after the Fontan Operation in a Population with Hypoplastic Left Heart Syndrome

    Eleni P. Asimacopoulos*, Steven J. Staffa, Peter C. Laussen, Kirsten C. Odegard

    Congenital Heart Disease, Vol.17, No.5, pp. 579-590, 2022, DOI:10.32604/chd.2022.020334 - 06 September 2022

    Abstract Background: Thromboembolic events are a cause of significant morbidity and mortality in the Fontan population. We previously reported on coagulation profile changes in a cohort of patients with hypoplastic left heart syndrome (HLHS) from Stage I through Fontan completion. In this report, we examine their clinical status, anticoagulation and incidence of thromboembolic events up to 20 years post Fontan. Methods: A retrospective chart review was conducted for twenty (20) surviving patients, from 1998 through December 2020. Patients who underwent orthotopic heart transplantation (OTx) were followed until their transplant. Patients who were found in the original study… More >

  • Open Access

    ARTICLE

    Results of Fontan in Patients with Apicocaval Juxtaposition or/and Separated Hepatic Venous Drainage

    Ju Wang, Shuo Dong, Jun Yan*

    Congenital Heart Disease, Vol.16, No.5, pp. 477-485, 2021, DOI:10.32604/CHD.2021.015016 - 03 June 2021

    Abstract Objective: Modifications of the Fontan operation, which are also known as total cavopulmonary connection (TCPC), are widely applied for patients with functionally univentricular hearts (FUH). Herein, we summed up the different surgical pathways and clinical outcomes in FUH patients with apicocaval juxtaposition (ACJ) or/and separated hepatic venous (SHV) drainage. Methods: Between January 2009 and December 2019, 123 patients who undergone TCPC in our institute were included in this retrospective study. We have included 70 patients with ACJ (Group 1) and 53 patients with SHV (Group 2). Moreover, Group 2 included 17 cases combing with ACJ (32.1%). In… More >

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